Neurosurgery Resident Physician Dell Medical School at The University of Texas at Austin
Introduction: This study tests the null hypothesis that there is no difference in pain control between patients receiving ESP blocks and those who do not. This retrospective study aims to evaluate the efficacy of ESP blocks in postoperative pain management and their impact on opioid consumption, recovery times, and patient-reported outcomes in individuals undergoing 1 or 2 level posterior lumbar surgery.
Methods: The study included 38 patients who received ESP blocks and 108 patients who did not. Demographic, clinical, and patient-reported outcome data were collected and analyzed.
Results: Demographics were comparable between the ESP block and no-block groups, with no significant differences in mean age (50.2 vs. 49.1 years), BMI (33.6 vs. 31.4), gender distribution (63.4% vs. 58.7% female), employment status (67% vs. 63%), CI (1.05 vs. 1.08), or smoking rates (7.6% vs. 9.7%). Mean ASA scores (2.6 vs. 2.5) and levels treated (1.2 vs. 1.2) were similar. The ESP block group had a longer mean operating room time (294.9±63.4 vs. 272.4±72.5 min) but lower estimated blood loss (207.3±190.4 vs. 220.7±143.9 ml). A smaller percentage of patients in the ESP block group required transfusion (12.9% vs. 25%). Patients receiving ESP blocks had lower mean total MME (304.9±296.4 vs. 327.1±278.4) and mean MME/day (88.1±60.8 vs. 94.7±49.1). The ESP block group also had shorter mean LOS (2.8±1.6 vs. 3.6±2.2 days) and greater mean postoperative ambulation distances (day 0: 46.7±34.2 vs. 22.7±17.6 ft, day 1: 258.4±244.3 vs. 238.1±210.6 ft, day 2: 283.6±238.5 vs. 261.7±168.9 ft). Mean postoperative pain scores (VAS) were similar between the groups.
Conclusion : This study suggests that Erector Spinae Plane (ESP) blocks may be effective in managing postoperative pain in patients undergoing lumbar spinal fusion surgery. The use of ESP blocks was associated with reduced opioid consumption, shorter hospital stays, improved ambulation, and comparable pain scores. Further research and prospective studies are needed to validate these findings and assess the long-term benefits of ESP blocks in this patient population.
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